危险货物污染危害性货物安全适运申报单.doc

危险货物/污染危害性货物安全适运申报单
Declaration on Safety and Fitness of Dangerous Goods / Hazardous Goods
(包装货物)
(Packaged)
进港Arrival□/出港Departure□
发货人:
Shipper:
收货人:
Consignee:
承运人:
Carrier
船名和航次:
Ship’s name & Voyage NO. :
装卸港:
Port of Loading:
卸货港:
Port of Discharging :
货物标记和编号,如适用,组件的识别符号或登记号:
Marks & Nos, of the Goods, if applicable, identification or registration number(s) Of the unit
正确运输名称*、危险类别、危规编号;包装类**、包件的种类和数量、闪点℃(闪杯)**、控制及应急温度**、货物为海洋污染物**、应急措施编号***
Proper shipping name*,IMO hazard class/ division, UN number, packaging group**, number and kind of packages, flash point (℃.),control and emergency temperature**, identification of the goods as MARINE POLLUTANT**, Ems No.***
总重(kg)
净重/净量
Total weight (kg)
Net weight (kg)
交付装运货物的形式:
Goods delived as :
□杂货
Break bulk cargo
□成组件
Unitized cargo box
□散货包装
Bulk packages
□散装固体
Solid in bulk
组件类型:
Type of unit :
□集装箱
Container
□车辆
Vehicle
□罐柜
Portable tank
□开敞式
Open
□封闭式
Close
如适合,在方框内划“×”
Inset“×”in appropriate box
*仅使用专利商标/商品名称是不够的,如适合:(1)应在品名前加“废弃物”;(2)“空的未经清洁含有残余物-上一次盛装物”;(3)“限量”**如需要,见《国际危规》 款***需要时
*Proprietary/trade names alone are not sufficient. If applicable : (1)the world “WASTE” should proceed name;(2)”EMPTY/UNCLEANED” or “RESIDUE-LAST CONTAINED”;(3)”LIMITED QUANTITY” the should be added.**When required in item ,volume 2 of the IMDG Code;***When req